Las concentraciones séricas de interleucina-6 y proteína C reactiva se incrementan a medida que la enfermedad de Chagas evoluciona hacia el deterioro de la función cardíaca

López, Leonardo Raffo; Arai, Kaduo; Giménez, Esther; Jiménez, Mariela; Pascuzo, Carmine; Rodríguez-Bonfante, Claudina; Bonfante-Cabarcas, Rafael

doi:10.1157/13083649

Cited by 41 publications

(9 citation statements)

References 18 publications

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“…In the present paper, we confirmed that CRP is a sensitive marker for the evolution of Chagas disease, especially at later stages related to the presence of heart failure (phase III). In this sense, it has been found that serum CRP levels only increase in the most advanced phase of the disease, indicating that CRP serum levels could be of prognostic value in assessing Chagas disease progression 2 , 18 , 21 .…”

Section: Discussionmentioning

confidence: 99%

“…The increased serum levels of CRP reflect a vascular inflammation state and they are associated with the development of cardiovascular events 4 . Increased levels of serum CRP have been reported in advanced clinical stages of Chagas cardiomyopathy 2 , 18 , 21 , however, this increase was similarly observed in non-chagasic cardiomyopathy 5 .…”

Section: Introductionmentioning

confidence: 87%

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Adenosine Deaminase Activity and Serum C-Reactive Protein as Prognostic Markers of Chagas Disease Severity

Bravo-Tobar

Nello-Pérez

Fernández

et al. 2015

Rev. Inst. Med. trop. S. Paulo

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SUMMARYChagas disease is a public health problem worldwide. The availability of diagnostic tools to predict the development of chronic Chagas cardiomyopathy is crucial to reduce morbidity and mortality. Here we analyze the prognostic value of adenosine deaminase serum activity (ADA) and C-reactive protein serum levels (CRP) in chagasic individuals. One hundred and ten individuals, 28 healthy and 82 chagasic patients were divided according to disease severity in phase I (n = 35), II (n = 29), and III (n = 18). A complete medical history, 12-lead electrocardiogram, chest X-ray, and M-mode echocardiogram were performed on each individual. Diagnosis of Chagas disease was confirmed by ELISA and MABA using recombinant antigens; ADA was determined spectrophotometrically and CRP by ELISA. The results have shown that CRP and ADA increased linearly in relation to disease phase, CRP being significantly higher in phase III and ADA at all phases. Also, CRP and ADA were positively correlated with echocardiographic parameters of cardiac remodeling and with electrocardiographic abnormalities, and negatively with ejection fraction. CRP and ADA were higher in patients with cardiothoracic index ≥ 50%, while ADA was higher in patients with ventricular repolarization disturbances. Finally, CRP was positively correlated with ADA. In conclusion, ADA and CRP are prognostic markers of cardiac dysfunction and remodeling in Chagas disease.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 87%

Adenosine Deaminase Activity and Serum C-Reactive Protein as Prognostic Markers of Chagas Disease Severity

Bravo-Tobar

Nello-Pérez

Fernández

et al. 2015

Rev. Inst. Med. trop. S. Paulo

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“…At present, the techniques of risk prediction in patients in the indeterminate phase of Chagas disease are based on the detection of cardiac wall motion abnormalities associated with functional and electrical defects. The presence of echocardiographic abnormalities in association with high interleukin-6 concentrations as a marker of myocardial injury has been highly predictive to screen patients for risk stratification (López et al, 2006 ). In this line, our findings demonstrating increased expression levels of circulating miR-208a during chronic indeterminate phase of Chagas disease should call attention to its predictive marker to identify patients at risk of developing chagasic heart disease.…”

Section: Discussionmentioning

confidence: 99%

Circulating Plasma MicroRNA-208a as Potential Biomarker of Chronic Indeterminate Phase of Chagas Disease

et al. 2018

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Chagas cardiomyopathy is the most severe clinical manifestation of chronic Chagas disease. The disease affects most of the Latin American countries, being considered one of the leading causes of morbidity and death in the continent. The pathogenesis of Chagas cardiomyopathy is very complex, with mechanisms involving parasite-dependent cytopathy, immune-mediated myocardial damage and neurogenic disturbances. These pathological changes eventually result in cardiac myocyte hypertrophy, arrhythmias, congestive heart failure and stroke during chronic infection phase. Herein, we show that miR-208a, a microRNA that is a key factor in promoting cardiovascular dysfunction during cardiac hypertrophy processes of heart failure, has its circulating levels increased during chronic indeterminate phase when compared to cardiac (CARD) clinical forms in patients with Chagas disease. In contrast, we have not found altered serum levels of miR-34a, a microRNA known to promote pro-apoptotic role in myocardial infarction during degenerative process of cardiac injuries thus indicating intrinsic differences in the nature of the mechanisms underlying the heart failure triggered by Trypanosoma cruzi infection. Our findings support that the chronic indeterminate phase is a progressive phase involved in the genesis of chagasic cardiopathy and point out the use of plasma levels of miR-208a as candidate biomarker in risk-prediction score for the clinical prognosis of Chagas disease.

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“…This balance promotes an anti-inflammatory state in heart tissue that counteracts necrotic phenomena, fibrosis and cardiac remodelling associated with severe inflammation ( Haskó et al 2008 ). Elevated levels of TNF-α and IL-6 have been associated with advanced stages of Chagas disease and negatively with the cardiac ejection fraction ( Mendoza et al 2005 , López et al 2006 ), while high levels of IL-10 have been observed in asymptomatic patients in the indeterminate phase of Chagas disease, and patients who have developed cardiac disorders have reduced levels of this cytokine ( Sousa et al 2014 ).…”

Section: Discussionmentioning

confidence: 99%

Dipyridamole potentiated the trypanocidal effect of nifurtimox and improved the cardiac function in NMRI mice with acute chagasic myocarditis

Santeliz¹,

Caicedo²,

Giraldo³

et al. 2017

Mem. Inst. Oswaldo Cruz

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BACKGROUND As chronic Chagas disease does not have a definitive treatment, the development of alternative therapeutic protocols is a priority. Dipyridamole (DPY) is an alternative to counteract the pathophysiological phenomena involved in Chagas cardiomyopathy.OBJECTIVE To evaluate the therapeutic efficacy of DPY associated with nifurtimox (Nfx) in epimastigote axenic cultures and in mice with acute Chagas disease.METHODS NMRI adult male mice were divided into nine groups: three healthy and six Trypanosoma cruzi-infected groups. Mice received vehicle, Nfx or DPY, alone or combined. The doses assayed were Nfx 10 and 40 mg/kg and DPY 30 mg/kg. The treatment efficacy was evaluated by clinical, electrocardiographic, parasitological, biochemical and histopathological methods.FINDINGS In vitro, DPY and Nfx had a trypanocidal effect with IC50 values of 372 ± 52 and 21.53 ± 2.13 µM, respectively; DPY potentiated the Nfx effect. In vivo, Nfx (40 mg/kg) with or without DPY had a therapeutic effect, which was reflected in the 84-92% survival rate and elimination of parasitaemia and heart tissue amastigotes. Nfx (10 mg/kg) had a subtherapeutic effect with no survival and persistence of amastigotes, inflammation and fibrosis in heart tissue; adding DPY increased the survival rate to 85%, and all tested parameters were significantly improved.MAIN CONCLUSION DPY has a trypanocidal effect in vitro and enhances the Nfx therapeutic effect in an in vivo murine model.

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Las concentraciones séricas de interleucina-6 y proteína C reactiva se incrementan a medida que la enfermedad de Chagas evoluciona hacia el deterioro de la función cardíaca

Cited by 41 publications

References 18 publications

Adenosine Deaminase Activity and Serum C-Reactive Protein as Prognostic Markers of Chagas Disease Severity

Adenosine Deaminase Activity and Serum C-Reactive Protein as Prognostic Markers of Chagas Disease Severity

Circulating Plasma MicroRNA-208a as Potential Biomarker of Chronic Indeterminate Phase of Chagas Disease

Dipyridamole potentiated the trypanocidal effect of nifurtimox and improved the cardiac function in NMRI mice with acute chagasic myocarditis

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